The diary of a triage nurse

I am a healthcare professional, an emergency triage nurse. In the following diary, I try to describe my experiences and feelings about this so far unknown, fearful epidemic. Don’t expect high literature, nor a professional paper. It is something else.

03.10.2020.

I had followed the news about coronavirus calmly, until the infection appeared in Italy as well.

It is a different culture, I calmed myself. Elderly people live active social lives there, they go out, socialise and often touch, kiss and hug each other. All the lovely and humane behaviour that I had so far missed from Hungarian mentality now appeared to be yet another opportunity to spread the infection. I felt frightened, anxious and excited at the same time. I watched the heroic struggle of the unknown Italian colleagues and wondered what if…? I couldn’t stop asking this, everybody discussed it at work too. Not like a gossip, but as a fear we share. Our supervisors informed us several times every day, showed us the protective gear that I had so far only seen on Insta or FB. We laughed, we wondered, but inside we all felt a very nervous anxiety.

We wait and hope that the cooler demeanour that Hungarians are accustomed to, and how we are only in close physical contact with those very close to us becomes a positive this time.

I am Ancsa, emergency triage nurse. I’m preparing for the task of fighting an unknown disease in the ER of a successful hospital. This anxious fear is a lousy feeling and I can only hope that it will bring the best out of us and me.

03.11.2020.

PANDEMIA

I have another night shift today. In the morning, during the bicycle ride home, I called my parents and my sister. I’m worried about them. I keep instructing them how to wash their hands, to stop using money, to use a credit card, and stay home. I’m tired but wound up.

I checked the news and the emails from my bosses. They contained precise instruction following those of the authorities. After a few hours of sleep I go online and watch the press conference of the operational group.

An emergency… The word that I live in, the one that has been a perfectly safe part of my life appears in a new role today. It’s the first time it makes me scared. I called my parents and sister. We chatted lightly, lovingly. They can sense my anxiety.

I went to work for the night. I started my shift and quickly got into the usual rhythm. I showed the patients waiting in the hall how to wash and disinfect their hands properly. They seemed to appreciate it.

It is a silent and warm spring evening outside. As I look at my phone, the first piece of news I see is PANDEMIA. The WHO announced it! They claimed this epidemic a pandemia at 10pm local time, 03.11.2020.

I had tears in my eyes, and felt like a part of history, just like the 7.5 billion other people. Our textbooks will come alive in the following period. My phone does not allow me to indulge in self-pity, worrying old friends, acquaintances call every few minutes. They are scared. So am I, but as I have no other option, I choose to consider this as a lesson from which I can learn a lot. Digital communication gives us a great advantage, so we have to use it to our advantage.

03.12. 2020.

After my shift, I spent some time with my colleagues. We listened to the news and talked. Last night, we got a load of emails again, detailing the regulations of precaution applying to us. It’s an abundance of information, hard to learn. There are hardly any patients at the ER, almost only drunken homelesses. It’s as if Budapest was empty. I haven’t seen a cystitis patient in days. It’s very scary. It’s like before a tsunami, when the sea recedes beforehand. Everyone is nervous, sometimes we snap at each other and bicker, but nothing serious, we know that we can only count on each other. It’s just to release the tension that has been winding us up for days.

After the morning chatter I biked home. I tried to sleep, but couldn’t, and gave up after 3 hours of slumber. My stomach hurts a bit, but it’s probably just the stress. I went shopping for some food. The meat shelves were almost empty at Tesco. A family bought up the last 10 kilos literally before my eyes. That’s fine, pasta is ok too, and sandwiches and sausages.

The ER is still completely empty. We got a tent to pretriage. (To assess the condition of the patients before entering the hospital. This is where the infected can be separated.)

We jumped a level. Nobody could rest properly, even though the whole department was empty. The silence is still scary.

03.13. 2020.

We become faceless people

90299594_200040757921792_771764881031430144_n

We talked a bit in the morning at shift change. Everyone circles around the tent getting to know the protective gear. Goggles, mask, overalls and gloves. This gear may save my life, but when I wear it, I won’t be Ancsa anymore. I will be one of the many faceless people, looking just like anyone else on duty. I slept 3 hours after great struggle. I even ate a few bites and drank a load of coffee. I answered some emails and talked to my family. I was numbly watching the press conference and fumbling with my phone when I got a message. “Have you heard?” “What?” “The quarantine!” What??? I went pale. My colleagues got quarantined for two weeks. I imagine quarantine like a prison for the goodies. Like a lesson of a sort. All I know is that you are not allowed to go outside or have contact with the outside world. Even its existence is hard to imagine until someone you know gets there.

03.14.2020.

 At work, I heard who had been quarantined. How could they have known the patient was corona positive? He had no typical symptoms. It’s such a sneaky virus, seriously! I hate it more and more… The management and the managing nurse persuaded the authorities that they would get quarantined here, at Uzsoki hospital. Home. That’s a bit of a relief. But this comfort was immediately gone as I saw the ambulance. The guy wore white overalls. Another faceless person. As the door opened, I saw people sitting, wearing medical masks. “Hi, Ancsa!”- I heard a familiar voice. I went closer and recognised my colleagues. I don’t wish this experience on anyone. I guess I arrived at the reality there, in that moment.

I am grateful to the FB and messenger, because it helps us to stay in contact with our locked up friends. We are also grateful to the management, they are like a candlelight in the dark.

03.15.2020.

Once again, in the morning I put off going home long. I talked to the guys, and we followed the news. Everyone is visibly tense. We are getting more and more nervous and the emails are getting more rigorous as well. They all have a weight and strength. I collect them, hate them but still read them. Sometimes I don’t even grasp the content. Like a student before finals, sitting in front of the door with a book on their lap mumbling in a no-input state. It feels dreadful. I talked to my family. I keep begging them to stay home. They promised and I believe them. They would never lie to me. I miss them.. My sister doesn’t let the kids to school either. They study at home and play. I don’t have to work tonight, but, of course, I cannot sleep. I talk to my family again, they are fine, and that finally calms me. It’s weird that they only live 10-20 km from me, it feels like a different continent. I am on call, like everyone else, so I can’t silence my phone. It keeps beeping constantly: email, sms, messenger, calls, it just can’t shut up. I learned that my colleagues have been transferred to home quarantine, meaning that they can wait at home, behind closed doors, patiently. That’s good… I guess it was the second best news this week. By 10pm I felt that I would be able to sleep.

03.16.2020.

I woke up at 5am. I checked the news, they gave me a stomach cramp. I have a headache too. I’m dehydrated. I had a tea and biked to the hospital. This trip was different from before. Something has changed. I could not tell what, but I can feel it deep inside.

There was a lot going on in the tent. The people waiting for their appointments at the gate just heard that according to a ministry decree, all appointments had been cancelled, and they were not allowed to enter. Some understood silently, some threatened that their death due to missing this appointment would be on me. A bunch of colleagues came from other departments. More and more wonder around the ER. It’s strange to see, as we were such a secluded world until now. Their care and help is touching. There are still very few patients coming. If an old patient with hypoxia arrives, we are startled. We explain to them why we are faceless and try to calm them. Everybody tries to help, they make all options available. We have protective gears which mean safety now. We can hardly eat. We are nervous… or exhausted, I don’t know.

It’s no better at home either, I’m all on edge and restless. I read my emails and see the press conference from yesterday. Cecilia Müller, the chief medical officer noted that the epidemic has jumped a level. We are no longer facing separate particular cases, but group infections the origins of which cannot be traced anymore. I guess I’m a bit scared. We are facing a savage virus that we know little of. Respiratory failure is a common case we are all familiar with as we have been in the field long enough. But we have never encountered it in a great number at the same time.

I don’t know what this misadventure is trying to teach us, but I believe that everyone needs to make sense of it for themselves so that we can move forward sensibly.

I’d better sleep now, in the morning everything starts again. I hope I’ll manage to sleep a few hours.

If possible, then please stay home. It’s not a request, it’s more like a plea. Every minute outside may increase the extent of this epidemic and the number of cases.

Stay home and hope with us!

 

03.17. 2020.

I CANNOT AFFORD TO STAY HOME- COVID TEAM

I woke up exhausted, I haven’t been able to sleep more than 3 hours for days, and that is not nearly enough. When I went to bed last night, I read through some emails, recommendations, orders of treatment. I don’t read news anymore, they freak me out. I got another email at night sometime between 1 and 2 am, the management sent the new orders of treatment. So they don’t sleep either… nobody does.

After the morning coffee and makeup (which is about as much use as a magic spell, it motivates inside, but quite ineffective outside), I hopped on my bike and went to work. It seemed like a Saturday morning in spring: the roads were all empty, so I got there quickly. I took over the shift, and we discussed the new order of treatment. All my colleagues look like panda bears with their pale faces and circles around the eyes. But the mood was good, we cracked jokes and teased each other. I could finally even eat a sandwich to my surprise, as I was not even hungry to begin with… But the smell of a good Gyulai sausage works wonders…

New people came to help again. Workers from the optometry department and from kindergartens helped us and secured the morning shift. The new development is the allocation plan after shift change. We discussed the daily action plan with the chief nurses. It was funny that the usually 5 minute long discussion now lasted 20 minutes, as one of our phones was always ringing. We appointed the COVID-TEAM. That was new, and a bit scary.

Then we assembled the whole shift together and explained to everyone their daily tasks, who would be responsible to which examining room. It was a bit like a field training exercise. These are necessary rounds. We constantly learn and strengthen ourselves inwardly. We checked the protective gear and the supplies, of which we have a safe amount. Sometimes I don’t even mind being in goggles and a mask all day, at least my tired face is hidden. Sometimes the chief appeared with some new info. We jokingly competed who slept less.

The hospital is still so empty you can almost hear the echo. It feels very odd. I suppose we have completely retreated to our own little universe. We didn’t even go to the café, despite that we like the food there, they have fresh schnitzel and buns. But somehow we did not feel like leaving our place. Maybe, because these days this is where we feel most at home. The chief physician asked one of his assistants to bake us a bundt cake. It was delicious, we almost forgot to breathe until we devoured it. The caring was very moving too. There are still very few patients in the ER, only really urgent cases come. That’s the most important result so far. There were also some interesting demands, but that didn’t surprise anybody.

90287326_205907410674559_588106873954107392_n

 

In the afternoon we played a team building game. I put on my suit, did my work, and then asked a colleague to help me take it off appropriately… well, it went fairly slowly. But that is extremely important! This bloody hot suit needs to be put on and taken off according to the manual! You cannot afford getting sick! You are needed!

At the end of our shift we just sat there in the changing room like bags of potatoes staring in front of us motionlessly. On the way home I called some buddies and friends who work in media communication. We try to organise everyone to help wherever they can. We all work in an amazing symbiosis. It was also nice to move out of the hospital environment mentally as well, even though we didn’t get very far, as the topic was still the effects of coronavirus, only from another perspective.

I’m exhausted now, I think I’ll be able to sleep properly. I need it badly, probably from Thursday on there will be loads to do. And that is only the beginning…

020.03.18

One of the most important things in an ER is to learn to take the increasing pressure

I got to bed at 1am. As soon as my head touched the pillow I fell asleep. I have dead annoying nightmares. Before I woke up I dreamt that I worked. I was in the ER at some meeting wearing protective overalls, and we were all yelling, because we couldn’t hear each other under the caps, but however we shouted, we couldn’t be heard because of the masks. Then I heard the sound of the tetra (the radio emergency units use to call us before they arrive with a patient). I jumped up and tried to struggle through the crowd. The phone woke me up, a colleague inquired about a patient from yesterday, but I interrupted her screaming “what day is it??” She didn’t know either. We burst out laughing.

I managed to go shopping and to the cosmetologist. I swear I felt as if I was a princess for a whole hour. In the supermarket the shopkeepers looked exhausted and chased. They spread the products at an amazing speed, while the customers stacked everything up in their carts without thinking. Human weakness could really surprise me sometimes. An old lady, who is otherwise probably really cute, bought up all the detergents from the shelves. I’ll never get the logic in that. Is perhaps washing clothes her mania?

Today I looked through my online stuff and the new FB. It’s a bit weird, but I think it will be very cool. I was a lot calmer today. I didn’t read the news. This quiet calm lasted until the afternoon. I shouldn’t read news until July.

In the evening, I packed my stuff for tomorrow. As I packed, my pulse kept increasing. I cannot stop being stressed. Seriously, when this whole mess is over I’ll have withdrawal symptoms. I keep training myself, and often think of my boss from the time when I was still a beginner. One day, after a tough shift he called me in his room, and told me “Ancsa, one of the most important things in an ER is to learn to take the increasing pressure. Accept that the pressure may grow from hour to hour while a situation may worsen practically minute by minute. Tonight I’ll go to sleep with this thought. And that I’m not alone. The whole staff of the ER and the hospital are now my closest colleagues.

  

03.19. 2020.

When the hospital being your second home is not just a joke

I finally managed to get 8 hours of sleep. I really needed that. I tumbled out into the kitchen and saw my writing on the fridge: “This is your day! It’s the award gala of the Anna Richter prize” with a to do list under: 9 o’clock, hairdresser, 11: cosmetologist then manicure. Arrival at the scene at 15. I stared at the list and felt sad. It could have been a defining day of my life. Instead fate gave me a defining month, or two, maybe three in the worst case. Everything changed within days. The past days seem like they were years ago with all their events and details, and the only thing left is the present and the near future. The 12 hours project is now waiting in a corner of my heart waiting until I fight coronavirus with my colleagues. I have to accept and incorporate this into my life now.

I could not spend much time with self-pity, because my phone warned me that I slept through 18 emails and about 3 dozens of messages. I turned on the computers and started doing my media work. That is what holds my head above water nowadays, by blog and the media work that gives me strength and momentum, to take this depressing madness with a sane mind. I read all the letters and messages. I managed to send the requested material to the advisory board 2 days after the deadline and upload the important infographics that advise people.

In the meantime informing letters keep coming from the hospital, and these have a priority now in all respect. The collegiality that joins the workers in the Uzsoki hospital now is really moving. As the situation may change hour from hour, the strategy must also adjust to the changes. We all live in and are shaped by a magical symbiosis. We are one team. We are taken care of in all possible ways, and that is so important, because we have never needed this extra care more. The hospital set aside a separated department for the exhausted workers, the “Hotel Uzsoki”. We will be able to rest there, if after some tiring shift, or between shifts we cannot go home.

The morning passed without me even noticing. I quickly numbed my stomach pain with a sandwich and packed up for the night shift still before the afternoon press conference. My pulse is once again between 90 and 100. I can feel the adrenalin flushing me. I was mad at myself for being so weak.

90531754_1059081767790876_3586912271915286528_n

I listened to the most important information from the press conference, then checked my watch. It was 16:30. The award gala that I waited so, that I was so excited about would have had started half an hour ago. I put on the dress I bought for the gala and my high heeled shoes, in which I practiced to walk resembling a woman. I dressed up pretty, yes. I deserved those quick 5 minutes in my beautiful dress and shoes. I wiped away some tears, but then pulled myself together and rode to the night shift.

03.21.2020.

It’s not panic, It’s fear

After six hours of sleep I woke up still tired. I didn’t feel like eating, so I turned on the computer trusting in the power of the morning coffee. I saw all the emails and messages on my phone, but couldn’t get myself to open them. The ringing of my phone makes me sick now. It’s a pushy little bastard. I pulled myself together and opened the inbox. I got about 70 emails, and found lots of followers of my page. The diary too. Perhaps it’s not useless to write.

Before opening my private emails, I felt a bit nervous. There is such an amount of emails coming every day, it makes me numb. I spend hours by the computer, memorising the most important recommendations that keep pouring on me sometimes in Hungarian, sometimes in English. I would like to do my best, so I read them all. Some of them are easier, caring letters. The management try to keep up the spirit, because they know that the past 2 weeks broke us all. And it all has not even begun yet…

I chatted with the first guests of the ”Hotel Uzsoki”. It feels great that our second home now actually becomes our second home. I might need it at some point as well. I wish I didn’t have these stupid thoughts. I wish this whole ordeal was already over.

I watched the press conference at 3 pm, but did not open any news sites. I just couldn’t. I’m literally sick of all the clickbait “let’s be angry together” type of news. If there is such a need for a common enemy, then why couldn’t this bloody virus be it?

I started getting ready and checked my schedule. I’ll work with a fine little team today. When I got ready, I took a deep breath and checked the news sites. I still had 20 minutes. I shouldn’t have…

There were almost 800 dead in Italy. It devastated me. I read the article frozen, and felt how I lost the track. It’ just not something I can comprehend. I looked at the unknown colleagues in the pictures, thinking that nobody deserves this. I’m scared. I’m worried about my family, my parents, my sister, and her little ones. I’m worried about myself, my colleagues and my sanity. I don’t know how I could endure a Bergamot-like situation here.

 

I rode my bike to work, and could feel how much cooler the weather has become. The cold didn’t bother me, it was rather refreshing. I called my parents and my sister. It was good to hear them. I talked to mum about cooking, then, with dad, we calculated mathematical probabilities. My sister and her family are also fine. It was good to hear the childrens’ noise from the background, it sounded like life itself.

But at work everything is different.

There, we endure the stress better. I cannot explain this. Perhaps it’s that we don’t have to explain our fears, as we all share this difficulty equally. When I got in, I heard that the director got us dinner. We got an astonishing quantity of pizza delivered. I hadn’t eaten all day. I took over the department, designated the tasks and put on the protective gear. I like them all. Although I look like a diving frog in the goggle-mask combo, I don’t care. Finally we stopped wearing our pretty blue gloves, instead, we got an undefined shade of blue that matches our paper gowns. The pizza was delicious, we got fresh bread with it. We ate until we became incapable to move. We laughed a lot. Finally the tension eased a little bit. A few patients came, but it’s not the real rush yet. It’s not that day yet…

03.22. 2020.

Some new colleagues came to visit today. Real experienced ER foxes. We were very happy about it. They work with quick, unhesitating moves and are super motivated. Of course, as they have lived in this for decades.

The department is relatively quiet. This pre-tsunami silence is still damned annoying. There are almost exclusively drunken hobos who drank themselves unconscious and found themselves passed out in the cool spring night. Early in the morning, a few people came, but no crowd. I stayed a bit to talk to the morning shift, listened to everybody’s stories and ate a pancake with nutella. I am a HUGE nutella pancake fan. This was the best breakfast in the past 2 weeks.

Now I woke up after 4 hours of sleep. I looked at today’s numbers and tried to explain the present situation to myself. People aren’t afraid, and they don’t understand why we are. Some elderly ladies and men called the department previously for a little bit of conversation and support, but I feel that many, and especially my generation, do not understand us. Perhaps they find that the numbers aren’t all that scary, and the panic is too big. Perhaps they don’t understand that what’s 130 today, can be 300 tomorrow, and 900 in 3 days. I’m a bit tired and I’m waiting for the night, it would be wonderful to sleep a whole eight hours like I used to, before..

 

03.24 2020.

Meeting the devil

You only start to miss everyday things when you lose them in a second. That’s what I’m facing. I’m anxious and depressed about being separated. Everything that worried me before now seems unimportant, but I miss physical contact with my loved ones. This nerve wrecking situation has only been going on for two weeks, but I can already feel its influence badly. I had to severe connection to everyone. I transport between work and my home, and sometimes buy some food at the local Tesco. That’s it, nothing more. I only get to meet my colleagues, they are my family now.

In the morning, like every day, I called my parents on the way to work. It was good to hear that they are fine, and to talk to mum about mundane things. We agreed that the safest is for them not to leave the house at all, while this pandemic lasts. It calmed her that I’m taken care of at work, and that I always wear appropriate protective gear, and we agreed that they ask me if they want to know how I am instead of listening to the news. I couldn’t talk to dad, so we agreed that I would call him in the evening on the way home.

At work, the “usual” routine calmed me a bit. We discussed the daily cases, and as there were a number of patients with suspected COVID, we talked about them too. We tried to estimate the chances, but it’s hard, as many still don’t take this epidemic seriously despite the ominous numbers, that have been spiking in the west, flashing at every news site. Of course we see this situation differently at the hospital. We, who work and live here, can all literally feel it all.

91344263_558134054817103_3472716783801073664_n (1)

The morning went by quite calmly. We went through the contents of the official emails. Then the director sent us a cake this morning. I love it when people have a sense of humour. Somehow I get on with them easier that with one dimensional “gecko” types. It was good to see the wide smiles on all the faces. First, I took the virus marzipan in my hands and declared myself a carrier, then poked it in the heart with a needle, and thus defeated it. It felt great, seriously. In the afternoon we even got pizza, so we faced the last 4 hours well-fed. Then we were dragged down into the swamp of reality so forcefully that I didn’t even have time to get scared.

This was the first day when I had to spend a longer period of time in the protective suits. It was the first time I had to see the value of my knowledge and group work. This is important, you have to realise, and keep repeating it to yourselves every day: “I have knowledge and experience and I am not alone.” The safety that I worried about previously was there with, beside and behind me all this time. We are a team and we work together.

Before I left for home, we talked a bit. We know, we can feel that it is here, it has begun.

I talked to dad a bit. I think he will shape a complete Japanese garden in the back yard by summer. I could also talk to my sister, they are also ok. I could hear the noise of the children through the telephone, which turned my evening nice, as I could feel, even though not personally, that they are out there, and through them, I am too.

 

03.25.2020.

Two weeks

Two weeks ago, the WHO announced the pandemic. Little did I know back then, what I was facing. I watched the news about Italy and was astonished to read the numbers. I knew we could not escape from it.

It’s been two weeks since, and my friends, my colleagues that I work with every day in the hospital, get out of the quarantine tomorrow. A lot has changed in the hospital since they’ve been in, so they will have to face a completely new situation. The ER got a new pre-triage tent and three exam rooms assigned to COVID cases, and many new colleagues who fight with us in the toughest times. There is a completely new routine for shift change and new roles and equipment that are regulated by strict rules. We will have to teach them the use of the protective clothing and all the new possibilities that the hospital provides for them. It will be completely new for them that almost everybody has gotten closer to each other. We are waiting for them so much! Finally, we won’t be the newbs any more…

Those sinister numbers have skyrocketed by today. The number of infected may get higher in Italy then in china, as there are 74.386 infected presently, and about 700 dead daily. The number of Spanish victims has increased incredibly quickly as well. The whole world is fighting a huge war against the disease. We still seem to be incapable to believe that this may happen to us some day as well. We prepare ourselves, and try to learn from every situation, and become able to recognise the symptoms of the illness. We would like to stand there prepared, when it all begins.

Almost everything has changed in the hospital. Whole departments were moved, new ones grew out of nowhere, got fitted and finished under a single night. We disinfect everything after everything and between everything. The disinfectant has dried our hands sore, and we don’t even mind, because our ruined skin means safety now.

In the past week we got a huge wave of love and care, like never before. We keep receiving letters, cheering messages, food, drinks, and all possible human gestures.

The past two weeks ran by quickly and brought lots of changes into our lives that we had to incorporate quickly. I completely lost my sense of time. I got miles away from the 12 hours project and the Richter Anna prize. Since the epidemic, the events of the not so distant past have been growing older and older every day. Everything changed around me incredibly. I hope I’ll get the chance to reach back for the missed opportunities and ripen them into experience. Unfortunately, under the circumstances, it was impossible to campaign, and that’s perhaps what feels the most painful to me. It would be so much simpler and nicer to know and plan the future.

 

03.26.2020.

The shadow of suspicion- Fighting an invisible enemy

I found it hard to come to my senses in the morning. Then I didn’t feel like doing anything: the news give me the creeps and I don’t even dare to look at Facebook. I only still read the internet because of the hilarious memes. Some of them make me laugh like crazy. I also enjoy the videos about people going nuts in quarantine. There is an incredibly vivid quarantine life on Facebook. It’s good to see how problems bring a sense of humour out of many.

I visited my sister today. The weather is nice, so biking isn’t so miserable anymore. I took advantage of it, and enjoyed the exercise. It was great to meet my sister even though we had to converse in the street by shouting at each other from three meters. I guess I got to feel the effects of social distancing. We can’t meet for weeks so we will have to video chat.

It is a bit calmer at the hospital now. Many have sunken into this new life that may bring serious losses to us. Everyone has to see, that the stagnation is seeming, we may drop into a new reality any moment, and then we’ll have to get used to that. We must not neglect anything, every new rule has to be practiced daily and we have to discuss all the remaining questions.

We also got a fabulous surprise. At the Facebook page of Uzsoki hospital, there is a video that will remain as a pleasant memory in our hearts. A squad of volunteer policemen came to applaud us with clapping and flashing blinkers. It was truly moving.

We have become cartoon heroes

91556987_2716381961941409_8073394182573522944_n

I tried on the condom-like plastic helmet. I start to look like a cartoon hero from the nineties saving the earth from the invasion of the swamp-monsters. I have to get used to it and accept that these new tools will become parts of my every day. It would be easier to get used to some romantic spring walks with ice cream.

So, protective gear. Wearing them is regulated by some pretty strict rules from which there are no exceptions. When the pre-triage personnel calls to a suspected COVID-case, we have to put the protective suits on and go to the COVID exam room. Every hospital follows this protocol. The COVID-care is spatially separated. The first such room in our hospital was the office of professor Hangody. He offered it. This is how I ended up working in the room of a living legend. We really try to keep the room neat, but it will probably need to be redecorated after the pandemic.

So, a patient with suspected COVID arrives. But who could be suspicious? Who gets separated from the rest?

The rules are simple. The only point for people to enter the hospital is the pretriage tent by the ER. This is where colleagues from other departments help us (and I’d like to thank them for coming and fighting with us). After a few questions and taking the temperature, the patients may go on into the hospital or the ER.

Everybody with a cough, fever, throat ache or asphyxia, or those, whose work requires close contact with other people are suspicious. In other words, almost everybody can be suspicious, even those, who aren’t. It’s unnerving, but that’s just how it is.

Whoever needs to be separated gets into another tent and waits for the COVID team to pick them up, or, if they arrived by an ambulance, then they are taken straight to the COVID exam room. Communication is very important to me. We are faceless in these protective clothes. The patients can see almost nothing from us, and unfortunately the mask even muffles our voice, so it is of utmost importance that we speak loudly and clearly. This, of course, also results in funny situations. A nice elderly man recently watched our attempts to communicate with a great sense of humour. He giggled a lot, though he was obviously unwell. We all really hope that his test will be negative and he will get well soon.

The rhythm in the examination room is actually pretty much the same as in any other exam room. We check out the patient, get an EKG, draw blood and give oxygen when necessary (and it generally is). The difference here is our clothing and the COVID test.

From the patients who exhibit symptoms, we take a sample that we send to a laboratory. According to the new regulations, we take the sample from the nose with a cotton swab, which is a bit unpleasant, but not painful. We reach up to the nasal cavity and rub the mucous membrane thoroughly, then remove the swab and keep it in a preservative. This closed vial is then sent to the lab with a form that we have to fill in precisely. After a chest X-ray, the patients get to a ward until their results are ready and they can be transferred to the appropriate therapeutic department. In our hospital, a part of building 16 and building C are assigned for this purpose. (I hereby send my greetings to my colleagues there! They spend all their workdays wearing protective gear from head to toe at the duration of this pandemic.)

We check out a number of suspected cases, which is exhausting both physically and mentally, but we all know that this is only the beginning. Times will come when we spend 12 hours dressed up from head to toe. Many of us are worried about it, but we’d like to be done with it, so we await that certain red day ready to fight.

03.27.2020.

This is a war too, only against an invisible enemy

I’ve been a bit calmer the past day, then the first piece of news I read this morning is that a restriction of movement is ordered from Saturday. Just before summer time. I can’t believe this is happening to me. We have expected this decision, what’s more, we’ve been waiting for it. Many don’t understand, as they still only see the number of cases, and don’t see the reason for this decision while there are only 300 patients in the country. Sometimes I feel that people are only willing to understand and accept exciting things. They extract the word “restriction” and place it beside the number 300, no matter how many times we explain, that this number is probably a lot more, they do not understand. Probably because they can’t see it. I hope they never will.

93356840_1470904149754386_3320325563113013248_n (1)

When I graduated from high school, my favourite chapter was the Second World War. I read a lot about how the war changed the whole society. Factories were changed to manufacture weapons and ammunition, and gear for the soldiers fighting at the front. It’s astonishing to see the similarities with the present. This is a war too, you know, only against an invisible enemy. The epidemic affects everybody. Some feel anxious, others show physical symptoms, and some claim to be unaffected while the nervousness almost shakes them apart, because their lives changed within a second.

I’ve changed too. I’m generally pretty disorganised, and being around organised people always seemed tiresome to me, but recently I started enjoying their company. I like working with them, because they are extremely cautious about hygiene. I think this virus scare is the hardest on them. One of these days I worked with such a person. She is so terrified of the possibility of an infection, it suffices to say coronavirus in front of her, and she rushes to the first tap to disinfect her hands. Later, when everything was so clean that I could have eaten the received gift pizza off the floor, we looked at the map of the infections. I looked at the astonishing numbers and the earth turning redder and redder. She was looking for opportunity. She started zooming in on the map and looked for civilised parts of the world, where the number of cases is still low. We ended up looking and the northernmost corner of Norway, where, I guess, the temperature doesn’t exceed 18°C even in the summer. She pointed at the map and gloriously announced: “This is it, that’s where I’ll move: 16. Hagenbyevegen str. Tromsø, Norway. I told her that everything is way to clean and neat there, but she found that very agreeable. I would like to go to Canada someday, or Amazonia, but I guess the best would be, If it all would just pass and I wouldn’t have to organise a one-hour long hand disinfection for a bloody sandwich, which is almost inedible because of all the disinfectant odour in the air.

The new lifestyle is slowly creeping into the hospital too. Everybody is preparing, everybody switched themselves to a new mode of functioning. We constantly discuss the official emails and analyse the new rules about our work. The management communicates with us daily, not only our direct supervisors, the director too. They are constantly present, even in the hardest situations.

It has begun

We got new gear and new patients. There are more and more patients every day. We spend more and more time in protective suits, and we find it less and less strange. It’s hard to diagnose this infection because it can be hidden. It’s not like a heart attack with typical symptoms, EKG pattern and blood work. This jerk of a virus is always just suspicious. And more and more asphyxiated patients come to the hospital feeling as if a heavy weight has been placed on their chest, and they have fever and a cough. Most of them are elderly: nice, honest grannies and grandpas who deserve better. They are alone, as visiting is forbidden, so we are the only ones they can count on. We send all patients to the isolated ward worrying about them and hoping for their recovery.

 

2020.03.28 

#everythinghaschanged

After a temporary calm the tension is increasing. I can sleep less and less again. The unfamiliar reactions of stressed people keeps surprising me. I don’t know how long this madness lasts, I hope not long. But I have no illusions, I know that the present and the near future wounds the souls of many people. My optimism and self-confidence is a bit broken, but I still trust that the people around me will be able to regain their original selves and so will I. After a little rest I read the emails. The amount of information in my inbox would have been impossible to imagine before. But at least there is information and communication. That is the most important to increase the sense of security of hospital employees. They don’t let us fly blind.

92155138_703055200437989_8779107951265710080_n (1)

Stress is the best diet. Whenever the pressure increases, I find it hard to eat. Now is no different. I need a few days to process the new information and situation. After some biscuits and tea I biked to the hospital. The number of patients in the ER keeps increasing, therefore the shift change takes a bit longer. If I intend to take the shift calmly without a rush, I’ll have to get to work an hour sooner.

In the first half of the night I ran around in a protective suit. There are more patients with assumed corona infection, so I had no choice. One of these times, as I entered the examination room, I was faced by two colleagues from the ICU. It took half a minute of standing and staring at each other to recognise each other behind the masks. It was a hilarious scene. Time seemed to stop in those thirty seconds. I had worked with them a few times before, when things were still normal. It’s probably due to their presence and confidence that I also felt calm and safe. I was grateful for that.

I worked through the night and the whole setting the clocks forward without even noticing. I don’t work today. My suit and goggles can rest 24 hours. A month ago I dreamt about going on a holiday for the first time in years. This morning I dreamt about a stress free sleep-day without stomach cramps. I try to stay in contact with old friends to divert my thoughts, but it keeps getting more challenging. Probably trying to think and chat about something else would just exhaust me even more. I hope they’ll forgive me.

 

03.30.2020.

I don’t even remember the last time I fell asleep at 9 pm. I woke up rested and fresh, and made a nice coffee. I got up a bit early, so I had time to read through my emails and the news. I’m getting unsensitised in this crazy news flood. All the sites just try to anger the people and that disturbs me more and more.

The roads are completely empty, so I biked to work like a maniac, thus I’m done with today’s training as well. The door slammed open in front of me, and immediately I was facing a slightly tipsy homeless detox patient asking for some change. I told him I wouldn’t give any, but I could give him food. He told me to sod of and that I was cheap. I felt insulted, seriously, he missed a great salami sandwich. The night shift team was all over the place, they were trying to wrap up their part of the COVID care. I got lucky: I’ve never liked shifts in the observation ward as much as nowadays. It’s like whipped cream on strawberries. I only had one patient sleeping peacefully as I took over the shift. He was waiting to get transferred to another department, so I had not much to do with him. I checked his vitals and changed his infusion. His doctor told me he still had to do some paperwork, so I had some free time to have breakfast.

The best part of my day arrived at noon. Recently, our mood has often been lifted with numerous gifts and donations from all over the town. We really appreciate the care, and enjoy that finally people recognise our work. The director of the hospital arranged that we get the donations in a continuous flow, the result of which is appreciated by all the employees.

In the afternoon, the events sped up a bit. Somehow the afternoons are always more messy. Patients with suspected COVID started to arrive. The peace and harmony was immediately gone. I took my share of the work, and soon found myself in the COVID exam room. One of the patients could breathe so difficultly that he had to sit down after two meters of walking. He said he had never felt so sick his entire life. He asked for some water, then he just held it in his hands for long minutes and sometimes took a little sip, because he found it so hard to drink. He had a fever and a cough and he was tired. I tried to encourage him. I told him that he was at the right place, in a good hospital, and he was going to recover. Sweat was pouring down my face and back, but I would have been ashamed to feel sorry for myself. While I thought really hard about a way to adjust my mask without touching my face, only by the movements of my mouth, because it was rubbing against my ears and nose, I saw a lady trying to lift her purse on the bed. It can’t have weighed more than 2 kilograms, but she just did not have the strength. I helped her and gave her her phone and dialled the number. While she talked, I quickly changed the infusion and checked the saturation curves. The lady called her neighbour to beg them to feed her kitten and also pet it a little bit, so that it won’t feel so lonely. My heart sank. I thought of Karcsi, my beloved cat. I could sympathise with her pain and worry. It diverted all my attention off my own childish problems. I talked to her about it a bit, she told me that the kitten had been rescued off the streets and is only 6 months old. That’s the best age, neither a grownup, nor a baby any more. I calmed the lady that kittens are faithful, and her little Squirrel will await her at home. It’s hard not to take these stories home with me…

I didn’t, I couldn’t have known, that I would also spend the night worrying about my cat, as he was completely fine when I said goodbye to him in the morning. Every day, when I get home, as soon as I open the door, Karcsi jumps straight into my arms purring, mewing, and complaining about nasty me leaving poor him alone. Then he runs to the fridge and waits for dinner. But today he did not come. He was lying in the bathroom crying. He could not go to the toilet. He was ill. We took him to the Animal Hospital Budapest and he had to stay there to recover and rest. They were very nice and empathetic, and they have been in contact with me, they even sent me an email with this photo.

My dear little clown, I hope he’ll get better soon. I swear, if he recovers, I’ll let him pack my stuff out of the wardrobe and sleep in the middle of the bed.

 

03.31.2020.

COVID TEAM – Uzsoki Eagles

I didn’t sleep much, almost nothing. I was worried about Karcsi, and had a bad conscience. I keep thinking that he got ill, because he had to spend so much time alone, even though I know that he spends 18 out of 24 hours asleep, two more half asleep. But those remaining four…

In the morning I was assigned to the COVID exam room, which got busy quickly, so I skipped breakfast. Few hours later, when I came out, there wasn’t much point in having breakfast anymore, so I waited for lunch. The events are speeding up now. The hospital keeps adjusting to the situation, so the strategy is daily updated and improved. A new short-term future is unfolding, and we’re trained and ready for it. I was neither nervous, nor stressed, the hospital started training us in time, although it was surely not easy, as it was a completely strange situation to get adjusted to, both as individuals and as a collective.

92039401_852259071954950_2428303676557754368_n

In the afternoon I was asked to work in the COVID-team. Of course I said yes, I didn’t even think about it. Many people are afraid of this task, but I see it differently. I don’t know if life will ever bring me another such huge opportunity to study a pandemic as an active participant, as a member of the team that treats infectious patients. I’m sure it will be exhausting and there will be times when I regret it, because it’s too much and it hurts, but I have to be involved, because I can learn something about this profession that will definitely be an advantage.

In the evening I talked to the animal hospital. Karcsi is feeling better and he has no fever, but he won’t eat. He never does when he has a boo-boo on his little soul. He must be very sad now, but I hope he will soon recover and change back into that spoiled cat that I have to keep reminding not to unpack my wardrobe, and not to bite the toes hanging out from under the covers, and not to mew into my face from 1cm if the alarm doesn’t wake me. I miss that little rascal, but I hope he wakes to a prettier day tomorrow.

04.01.2020.

Today I decided that I will not watch or read the news anymore until the end of summer. Sometimes it is a challenge to survive just looking at FB. If we are so determined to hate someone and have nothing better to, then everybody should hate the virus and life will be so much easier. I spent my morning trying to accept this crazy and toxic arsenal of news.

I’m not working today, which is a bonus. I tried to put together a to-do list for this day-off, but then managed to do nothing. I spent the whole day in front of my computer trying to read through the literature. I don’t know how other people manage, but I’m afraid I’ll have withdrawal symptoms after all of this. All that’s happened in the near past seems decades ago. Recently, my biggest worry was to be able to walk in high heels at the gala of the Richter Anna prize, today, my smallest worry is that I’m out of painkillers, so I had to endure the splitting pain that started when I skipped another meal.

The vet’s office called me, they were very nice. They told me that my little prince is better, but he still won’t eat or drink, although he loves to eat and it’s already been two days. Now he’s getting fluids by infusion. When I hang up, I burst into tears, even though I’m not the crying type. I think it was helplessness that made me cry more than anything. What matters is that he can come home tomorrow. I hope he’ll regain his appetite at home.

The news of the day came in the afternoon. The fogjunkössze.hu (let’s join forces) site has just been launched! It’s brilliant and the idea came from our hospital. Many citizens who are willing to help are just looking for the opportunity. This site is meant to coordinate requests and offers. Of course, the state helps as well, as protective gear and these major tools come from the taxpayers, but they cannot manage to organise everything. The site will give a great way to help and it will steer the minor offerings to where they are needed most.

The initiative was the idea of the director of the hospital, dr. Andrea Ficzere. The concept is to stop inequalities:  I, for instance, gained 2 kilos due to all the food we are given, while another hospital looked like a cemetery from all the flowers they were sent. It was pretty, but it could have been pretty elsewhere too, and the employees would really have gladly traded a few geraniums for an XXL pizza. On the other hand, some hospitals were a bit neglected, as they are in the outskirts, even though doctors and nurses fight just as hard against the epidemic there.

It is rather strange, that even on my day off I’m mentally in the hospital, I cannot stop myself. I’m continually in connection with everyone who is on shift, even when I’m not. The continuous flow of emails and the good natured teasing makes me feel at home.

Tomorrow I’m starting my first day with the COVID ER team. I’m a bit nervous, but can hardly wait. I’d like to learn, see and experience a lot. I’d like to get to know the virus.